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Hearing management

Updated 07 December 2017

Antibiotic gel – future treatment for kids' ear infections?

An experimental therapy which involves applying antibiotic gel into kids' ears to treat bacterial infections has been successfully tested in chinchillas.

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A single application of an antibiotic gel into the ear might one day offer kids and parents an easier way to treat bacterial ear infections, new animal research suggests.

'Otitis media'

So far, this experimental therapy has been tested only in chinchillas. But it did cure 100 percent of the animals' ear infections.

Whether the therapy will work in children is still unknown.

Middle ear infections, known as otitis media, are an extremely common problem in kids, and parents often struggle getting their children to take the medicine.

Read: Ear infection can disrupt a child’s life

"Right now, the way otitis media is treated is with a three-times-a-day, 10-day antibiotic course, and it tends to be pretty much full-contact wrestling to get kids to take the antibiotics – that is one problem we set out to address," said lead researcher Dr Daniel Kohane. He's director of the Laboratory for Biomaterials and Drug Delivery at Boston Children's Hospital.

Kids may fail to complete the full oral antibiotic therapy, which can increase the risk of bacterial resistance, as all of the bacteria may not be killed, Kohane said.

Directly into the middle ear

Finding ear drops to treat otitis media has been a long-sought goal. But drugs inserted into the ear are usually blocked by the eardrum, so they never reach the bacteria in the middle ear, the researchers explained.

The new gel, however, contains fats that help the antibiotic cross the eardrum, where the antibiotic is slowly released over a week. The gel contained the antibiotic ciprofloxacin.

Read: Magic as Cape Town baby hears for the first time

The chinchillas tested had a bacterial infection caused by Haemophilus influenzae bacteria, a common cause of otitis media, according to Kohane.

All 10 chinchillas who received the new gel were cured of their ear infections. Only five of eight chinchillas who received standard antibiotic ear drops were cured by day seven, the study found.

The gel delivered the drug directly into the middle ear. The drug wasn't seen in the bloodstream. That suggests that this targeted treatment won't affect the whole body and kids may be spared the adverse side effects of antibiotics, such as diarrhoea and rashes, Kohane said.

Still a long way to go

The study authors also said that avoiding systemic (full-body) exposure to ciprofloxacin is particularly important because it's not recommended for use in children due to potential harm to their bones and muscles.

Within three weeks, the gel was gone and the chinchillas' eardrums appeared normal, the study found.

Because the chinchilla's ear is like a human ear, "we would expect it to work in humans," Kohane said.

However, research that looks promising in animals often fails to yield similar results in humans.

There's still a long way to go before this treatment could be used on infants and toddlers.

Read: Ear infections often missed in infants

A series of tests in humans needs to be done to be sure the drug is safe and effective and has no serious side effects. Kohane is looking for a commercial partner to fund and eventually manufacture the gel and its applicator.

Fewer oral medications

If this new treatment pans out, it would go a long way to making these infections easier to treat, Kohane said. "Our hope is that this would totally change the way otitis media infections are treated," he said.

At least one paediatric care expert agreed.

"It would be great to have something like this available," said Dr Jose Rosa-Olivares, director of the paediatric care centre at Nicklaus Children's Hospital in Miami.

In addition to taking antibiotics, kids may also be taking other medicines to fight the fever that goes along with the ear infection. Applying this gel would cut the number of oral medications a child would be taking, which would make treating the infection easier, he said.

"Otitis media infections in children are an extremely common reason for doctor and emergency room visits. So, to be able to provide a treatment that decreases the need to give an oral medication and improve compliance would be looked on favourably," Rosa-Olivares said.

The report was published in the journal Science Translational Medicine.

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Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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